Providing Effective MTM

DECEMBER 01, 2006

Fred M. Eckel, RPh, MS; Pharmacy Times Editor-in-Chief

In an era of shrinking dispensing fees,
many of us have advocated a shift
toward a new model for the professionone based more on counseling and
less on simply dispensing drugs. Medicare
Part D, despite all the stress and problems
it has generated, created just such an
opportunity by including a requirement for
medication therapy management (MTM).

Even though this part of the program is
just getting started, the potential is considerable.
A few plans have set up pharmacy-centered MTM services. For example,
about 120,000 patients are required
to receive MTM by the end of 2006
through the National Community Pharmacists
Association's Community MTM
program.

One might have expected pharmacists
to jump on this, given the many surveys
that have indicated we want to spend
more time providing patient-focused
services. Feedback to date, however,
shows that many of us are not taking
advantage of the opportunity.

Practical reasons for this exist. When
resources are already overstretched, it
is hard to justify hiring staff for a new,
unproven line of business. Furthermore,
each plan currently adds to our administrative
burden by requiring us to learn
and use a different system. Perhaps the
biggest challenge is to change our own
mindset so that we see ourselves as
providers of services rather than just
drugs.

By making this shift, pharmacists can
position themselves to step into valuable
new roles. Research suggests that MTM
can reduce drug costs and, even more
important, the risk of adverse interactions.
The Part D MTM requirement covers
situations in which patients are treating
chronic conditions with multiple
drugsthe type of situation in which
pharmacists should excel in providing
drug therapy advice.

Now, it is up to us to demonstrate
that we are the profession best qualified
to provide this service.We need to
show both the ability and the desire to
provide MTM, and to demonstrate that
this is a valuable service both for
patients and for plans.

If we accept the challenge and provide
MTM effectively, we will begin to position
pharmacists as valuable resources for
advice. That, in turn, will pave the way for
us to deliver more services in the future.

When creating the Part D MTM
requirement, legislators did not specify
who should deliver it, and many insurers
are initially choosing to provide
MTM by other means. If we do not
demonstrate that pharmacists are the
best providers of counseling services,
we may be opening the door to allow
others to claim that role.

Mr. Eckel is professor and director ofthe Office of Practice Developmentand Education at the School ofPharmacy, University of NorthCarolina at Chapel Hill.